| NPI | 1366763344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN 63061) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2016-00772) |
| 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: TN 63061) | |
| Enumeration Date | 2010-06-14 |
| Last Update Date | 2024-01-17 |