| NPI | 1326368085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: PA OS017459) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 34.009245) |
| Enumeration Date | 2010-06-04 |
| Last Update Date | 2015-10-03 |