| NPI | 1366896607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: AZ 66995) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX BP10056162) |
| 207X00000X Orthopaedic Surgery (Licence: MO 2021013955) | |
| Enumeration Date | 2016-04-22 |
| Last Update Date | 2022-08-29 |