| NPI | 1124056023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NH 17285) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CT 043304) |
| 207X00000X Orthopaedic Surgery (Licence: PA MD429866) | |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2023-03-07 |