| NPI | 1851828735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101277238) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD477480) |
| Enumeration Date | 2017-05-22 |
| Last Update Date | 2023-03-24 |