| NPI | 1386614311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: GA 72570) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX K3694) |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2023-03-20 |