| NPI | 1518495381 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: LA 335419) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 314713) |
| 207X00000X Orthopaedic Surgery (Licence: MA 271501) | |
| 207X00000X Orthopaedic Surgery (Licence: MA 282683) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: LA 335419) | |
| Enumeration Date | 2017-05-24 |
| Last Update Date | 2023-08-01 |