| NPI | 1457613150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: AZ 48607) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A145807) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NM MD2018-0175) | |
| Enumeration Date | 2012-06-09 |
| Last Update Date | 2021-05-26 |