| NPI | 1013390533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A170363) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX BP10053395) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: CA A170363) | |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2020-12-01 |