| NPI | 1548252406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MA 78482) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NH 13243) |
| Enumeration Date | 2005-08-17 |
| Last Update Date | 2023-12-21 |