| NPI | 1992117089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AR E-19268) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX BP10050668) |
| 207X00000X Orthopaedic Surgery (Licence: AL MD.45810) | |
| 207X00000X Orthopaedic Surgery (Licence: MN 64968) | |
| 207X00000X Orthopaedic Surgery (Licence: RI MD19310) | |
| 207X00000X Orthopaedic Surgery (Licence: NY 332989) | |
| 207X00000X Orthopaedic Surgery (Licence: FL ME160231) | |
| 207X00000X Orthopaedic Surgery (Licence: GA 94286) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: ME MD27806) | |
| Enumeration Date | 2014-05-23 |
| Last Update Date | 2025-05-22 |