| NPI | 1124024674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CT 28175) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CT 028175) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: CT 28175) | |
| Enumeration Date | 2005-06-21 |
| Last Update Date | 2022-03-07 |