| NPI | 1306828249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MA 151694) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: MA 151694) |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2024-10-14 |