| NPI | 1144630161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: DC MD048046) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101268673) |
| 207X00000X Orthopaedic Surgery (Licence: MD D88907) | |
| 207X00000X Orthopaedic Surgery (Licence: DC MD048046) | |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: VA 0101268673) | |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: MD D88907) | |
| Enumeration Date | 2014-04-29 |
| Last Update Date | 2020-07-30 |