| NPI | 1558363853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: MI 5101006977) |
| Additional Taxonomies | 174400000X Specialist (Licence: MI 5101006977) |
| 207X00000X Orthopaedic Surgery (Licence: MI 5101006977) | |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2015-01-12 |