| NPI | 1104098136 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OR MD227937) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 42577) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: AZ 42577) | |
| 207X00000X Orthopaedic Surgery (Licence: AZ 80867) | |
| 207X00000X Orthopaedic Surgery (Licence: NY 260862) | |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: OR MD227937) | |
| Enumeration Date | 2008-03-31 |
| Last Update Date | 2026-07-28 |