| NPI | 1215192273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 51856) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD448818) |
| 207X00000X Orthopaedic Surgery (Licence: NJ 25MA09317700) | |
| 207XS0106X Orthopaedic Surgery Hand Surgery (Licence: OH 3512380) | |
| Enumeration Date | 2008-07-18 |
| Last Update Date | 2022-07-21 |