| NPI | 1881892172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MD D96137) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101274406) |
| 207X00000X Orthopaedic Surgery (Licence: PA MD453246) | |
| 207X00000X Orthopaedic Surgery (Licence: NJ 25MA08481300) | |
| Enumeration Date | 2007-07-07 |
| Last Update Date | 2023-03-24 |