| NPI | 1487141578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ME MD27118) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35.99999) |
| 207X00000X Orthopaedic Surgery (Licence: NY 307244) | |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2023-12-22 |