| NPI | 1598112013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: TX T6633) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: UT 12229810-1205) |
| 207X00000X Orthopaedic Surgery (Licence: TX T6633) | |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: UT 12229810-1205) | |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2023-05-24 |