| NPI | 1578974994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MA 283397) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NH 20487) |
| Enumeration Date | 2014-05-20 |
| Last Update Date | 2024-11-08 |