| NPI | 1194164244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: MO 2013020328) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2013020328) |
| Enumeration Date | 2013-06-21 |
| Last Update Date | 2020-09-29 |