| NPI | 1851778401 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NC 2024-03192) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: VA 0101260856) |
| 207X00000X Orthopaedic Surgery (Licence: MA 295559) | |
| Enumeration Date | 2015-05-04 |
| Last Update Date | 2025-02-19 |