| NPI | 1174886733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: LA MD.207525) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: LA MD.207525) |
| 207XP3100X Orthopaedic Surgery Pediatric Orthopaedic Surgery (Licence: TX BP20044624) | |
| 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: IL 125064282) | |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2019-02-11 |