| NPI | 1568646800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MA 1017631) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD450545) |
| 207X00000X Orthopaedic Surgery (Licence: VA 0101250037) | |
| 207X00000X Orthopaedic Surgery (Licence: NJ 25MA09385400) | |
| 207X00000X Orthopaedic Surgery (Licence: RI 14940) | |
| 207XP3100X Orthopaedic Surgery Pediatric Orthopaedic Surgery (Licence: PA MT205521) | |
| Enumeration Date | 2007-12-21 |
| Last Update Date | 2023-12-12 |