| NPI | 1437564150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101275083) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: DC MD047881) |
| 207X00000X Orthopaedic Surgery (Licence: MD D83628) | |
| 207X00000X Orthopaedic Surgery (Licence: CA A130780) | |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2022-08-10 |