| NPI | 1144297250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: AZ 30290) |
| Additional Taxonomies | 174400000X Specialist (Licence: AZ 30290) |
| 207X00000X Orthopaedic Surgery (Licence: AZ 30290) | |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2014-04-24 |