| NPI | 1295946283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: CO 46601) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301081956) |
| 207X00000X Orthopaedic Surgery (Licence: CO 46601) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2017-04-13 |