| NPI | 1487036190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SD 12523) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KS 04-42960) |
| 207X00000X Orthopaedic Surgery (Licence: NE 34001) | |
| 207X00000X Orthopaedic Surgery (Licence: IA MD-48219) | |
| 207X00000X Orthopaedic Surgery (Licence: NE 7432) | |
| Enumeration Date | 2015-06-18 |
| Last Update Date | 2025-12-10 |