| NPI | 1689666547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MA 56268) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NH 11614) |
| Enumeration Date | 2005-08-17 |
| Last Update Date | 2025-02-03 |