| NPI | 1083971691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: AZ 72128) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: MO 2017007975) |
| 207X00000X Orthopaedic Surgery (Licence: GA 080377) | |
| Enumeration Date | 2012-04-19 |
| Last Update Date | 2024-07-03 |