| NPI | 1396292603 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: MA 1019486) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PR 21777) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: CA A184415) | |
| Enumeration Date | 2016-09-02 |
| Last Update Date | 2024-09-09 |