| NPI | 1366736928 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: WI 69295) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 69295) |
| Enumeration Date | 2011-06-01 |
| Last Update Date | 2023-09-12 |