| NPI | 1093004350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: SC 39926) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL OS13810) |
| 207X00000X Orthopaedic Surgery (Licence: PA OT014290) | |
| Enumeration Date | 2011-04-06 |
| Last Update Date | 2022-07-20 |