| NPI | 1134515091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PR 22339) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PR 13933) |
| 207X00000X Orthopaedic Surgery (Licence: MN 69031) | |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: MN 69031) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: MN 69031) | |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2022-08-25 |