| NPI | 1902813165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN 45681) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MS 21318) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: FL ME120771) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2022-07-21 |