| NPI | 1932693280 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: GA 99894) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL TRN27081) |
| 207X00000X Orthopaedic Surgery (Licence: PA MD481748) | |
| Enumeration Date | 2018-06-20 |
| Last Update Date | 2024-07-23 |