| NPI | 1255539938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD442158) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME152741) |
| 207X00000X Orthopaedic Surgery (Licence: NY 303276) | |
| 207X00000X Orthopaedic Surgery (Licence: NJ 25MA09379500) | |
| 207X00000X Orthopaedic Surgery (Licence: MO 2012003480) | |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2022-02-24 |