| NPI | 1083152938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: TX T9178) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA 1753) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TX T9178) | |
| Enumeration Date | 2017-02-10 |
| Last Update Date | 2022-09-12 |