| NPI | 1598743908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CT 53876) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101040813) |
| 207X00000X Orthopaedic Surgery (Licence: NJ 25IA12934300) | |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2025-12-17 |