| NPI | 1497250724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NH 25586) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NH 25586) |
| 207X00000X Orthopaedic Surgery (Licence: MA 1013441) | |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2024-12-04 |