| NPI | 1346406956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: OH 35095641) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN 62950) |
| 207X00000X Orthopaedic Surgery (Licence: IL 12504972) | |
| Enumeration Date | 2008-08-03 |
| Last Update Date | 2023-07-26 |