| NPI | 1164628921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD452480) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 303063) |
| 207X00000X Orthopaedic Surgery (Licence: NC 2013-01222) | |
| 207X00000X Orthopaedic Surgery (Licence: NJ 25MA09642900) | |
| 207X00000X Orthopaedic Surgery (Licence: FL ME152721) | |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2022-02-23 |