| NPI | 1114214970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A149738) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: CA A149738) |
| 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: MO 2016008225) | |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2022-10-21 |