| NPI | 1609040567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: ID M-12589) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 47374) |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2015-03-17 |