| NPI | 1851511521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NH 15958) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VT 042.0012652) |
| 207X00000X Orthopaedic Surgery (Licence: MA 1015099) | |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2023-04-13 |