| NPI | 1962841452 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: MA 1016407) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA 20A18210) |
| 207X00000X Orthopaedic Surgery (Licence: NJ 25MB10270300) | |
| 207X00000X Orthopaedic Surgery (Licence: GA 90781) | |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2023-10-31 |