| NPI | 1558400572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NM MD2010-0235) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NM 2004-0382) |
| 207X00000X Orthopaedic Surgery (Licence: NM MD2010-0235) | |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2013-07-12 |