| NPI | 1588920474 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: AZ 53409) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 53409) |
| 207X00000X Orthopaedic Surgery (Licence: PA MT202018) | |
| 208600000X Surgery (Licence: AZ 49614) | |
| Enumeration Date | 2012-04-05 |
| Last Update Date | 2022-10-18 |