| NPI | 1578756508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: MN 50532) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NY 233327-1) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NJ 25MA0859000) | |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2024-05-10 |