| NPI | 1205802634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 200700880) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 053402) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NC 200700880) | |
| Enumeration Date | 2006-02-25 |
| Last Update Date | 2023-05-24 |