| NPI | 1104873454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NC 2005-01876) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2005-01876) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2023-03-07 |