| NPI | 1598175390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: TX t9686) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A133997) |
| 207X00000X Orthopaedic Surgery (Licence: WA MD60899476) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: FL ME153253) | |
| Enumeration Date | 2014-05-01 |
| Last Update Date | 2024-02-19 |