| NPI | 1417339375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: MN 66592) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2021017680) |
| 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: MO 2021017680) | |
| Enumeration Date | 2015-06-26 |
| Last Update Date | 2023-07-19 |