| NPI | 1063775351 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: MD D0099054)  | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: DC MD500002586)  | 
| 207X00000X Orthopaedic Surgery (Licence: MD D0099054)  | |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: DC MD500002586)  | |
| Enumeration Date | 2012-06-21 | 
| Last Update Date | 2024-09-03 |