| NPI | 1548794647 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC 89677) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT213956) |
| 207X00000X Orthopaedic Surgery (Licence: NY 314949) | |
| Enumeration Date | 2017-04-14 |
| Last Update Date | 2023-11-08 |