| NPI | 1417341314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: VA 0101273002) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: UT 10092318-8905) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NC 259810) | |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2023-08-15 |