| NPI | 1366862666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NC 2019-00132) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX S5851) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: TX S5851) | |
| Enumeration Date | 2014-04-24 |
| Last Update Date | 2023-12-28 |