| NPI | 1568773463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 284846) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 55209) |
| 207X00000X Orthopaedic Surgery (Licence: NJ 25MA11410700) | |
| 207X00000X Orthopaedic Surgery (Licence: CT 56755) | |
| 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: NY 284846) | |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2024-05-21 |