| NPI | 1619976826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: VA 0101231604) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101231604) |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2017-12-05 |