| NPI | 1376643031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NY 342208) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 060601) |
| 207X00000X Orthopaedic Surgery (Licence: FL ME145843) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: FL ME145843) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: GA 060601) | |
| Enumeration Date | 2006-09-23 |
| Last Update Date | 2026-04-17 |