| NPI | 1003259706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: CT 72658) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CT 72658) |
| Enumeration Date | 2013-04-11 |
| Last Update Date | 2022-10-19 |