| NPI | 1295898740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0102202081) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2018-01935) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NC 2018-01935) | |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2021-09-03 |