| NPI | 1255319869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA G172374) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: LA MD.205141) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: MA 80940) | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: MA 80940) | |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2024-06-17 |