| NPI | 1013164243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: SC 35150) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A92667) |
| Enumeration Date | 2008-08-19 |
| Last Update Date | 2020-10-14 |