| NPI | 1942260880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NE 21762) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IA MD-35781) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: IA MD-35781) | |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NE 21762) | |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2024-11-04 |