NPI | 1124221601 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MS AU5009697-1056) |
Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: MS 2011w244) |
207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: TN 47283) | |
Enumeration Date | 2007-06-11 |
Last Update Date | 2019-09-08 |