| NPI | 1306340229 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CT 77032) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA11710300) |
| 207X00000X Orthopaedic Surgery (Licence: NY 327454) | |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: PA MD479663) | |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2024-03-13 |