| NPI | 1568568152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: CA G 57052) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: KY 40074) |
| 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: KY 40074) | |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2012-11-15 |