| NPI | 1124556881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MS V0121) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: TX V0121) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: TX V0121) | |
| Enumeration Date | 2017-05-25 |
| Last Update Date | 2024-08-07 |