| NPI | 1497952063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA OS016005) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2015-00346) |
| 207X00000X Orthopaedic Surgery (Licence: MN 53802) | |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: MN 53802) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: MN 53802) | |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2023-01-27 |