| NPI | 1558524835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC 34091) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KY R1181) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: CA A111645) | |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2018-03-09 |