| NPI | 1346575081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: AZ 006433) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 58.003264) |
| 174400000X Specialist (Licence: AZ 006433) | |
| 207X00000X Orthopaedic Surgery (Licence: AZ 006433) | |
| 208600000X Surgery (Licence: AZ 006433) | |
| Enumeration Date | 2009-10-14 |
| Last Update Date | 2021-01-29 |