| NPI | 1528028610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NH 11504) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VT 0420010413) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2021-03-29 |