| NPI | 1801042106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NE 27717) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IA MD-42090) |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2024-09-09 |