| NPI | 1265722698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: GA 77758) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WV 27416) |
| 207X00000X Orthopaedic Surgery (Licence: ZZ 110573) | |
| Enumeration Date | 2011-04-19 |
| Last Update Date | 2024-02-15 |