| NPI | 1962062828 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NE 36752) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IA MD-54388) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: IN 01093372A) | |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: IA MD-54388) | |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NE 36752) | |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2025-09-10 |