| NPI | 1184972366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: TX S1880) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA11135800) |
| 207X00000X Orthopaedic Surgery (Licence: TX S1880) | |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NJ 25MA11135800) | |
| Enumeration Date | 2012-08-20 |
| Last Update Date | 2024-02-14 |