| NPI | 1528412236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: FL OS17563) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NJ 25MB12787200) |
| 207X00000X Orthopaedic Surgery (Licence: MN 81438) | |
| Enumeration Date | 2016-04-19 |
| Last Update Date | 2025-12-21 |