| NPI | 1528129335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: VA 0101252498) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL TRN10212) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: PA MD443788) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NY 260774) | |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2022-11-23 |