| NPI | 1962607424 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 072421) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: OH 34009678) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NJ 25MB08109900) | |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2021-10-27 |