| NPI | 1407055098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: SC 36192) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD 22138) |
| 207X00000X Orthopaedic Surgery (Licence: NC 2012-00698) | |
| 207X00000X Orthopaedic Surgery (Licence: SC 36192) | |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2016-07-01 |