| NPI | 1760913859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NY 323412) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD61260401) |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2025-05-19 |