| NPI | 1437102621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: VA 01011236061) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0101236061) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2019-08-15 |