| NPI | 1508206111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NE 31756) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 55398) |
| 207X00000X Orthopaedic Surgery (Licence: IA MD-46302) | |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: IA MD-46302) | |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NE 31756) | |
| Enumeration Date | 2013-06-27 |
| Last Update Date | 2024-11-04 |