| NPI | 1336302504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 62217) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX BP10026870) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NY 261768) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: PA MD440658) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: CA A120685) | |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2021-11-23 |