| NPI | 1396069811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: OR MD177823) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 261815) |
| Enumeration Date | 2010-03-26 |
| Last Update Date | 2022-10-05 |