| NPI | 1518909738 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101043135)  | 
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: VA 101043135)  | 
| Enumeration Date | 2006-06-12 | 
| Last Update Date | 2020-06-01 |