| NPI | 1619359106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: PA MD469398) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2020012377) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: MO 2020012377) | |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2021-11-03 |