| NPI | 1518136225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: TX N7932) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME109691) |
| Enumeration Date | 2008-02-27 |
| Last Update Date | 2022-10-23 |