| NPI | 1285169441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: OH 35.138482) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35.138482) |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: OH 35.138482) | |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: GA 91359) | |
| Enumeration Date | 2017-04-25 |
| Last Update Date | 2025-05-14 |