| NPI | 1396162178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: ID O-1354) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: ID O-1354) |
| 207X00000X Orthopaedic Surgery (Licence: PA OS020063) | |
| Enumeration Date | 2014-03-18 |
| Last Update Date | 2023-12-05 |