| NPI | 1578802401 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: CA A172375) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 264398) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: MA 264398) | |
| Enumeration Date | 2013-02-13 |
| Last Update Date | 2021-09-02 |