| NPI | 1629262183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: CA A125009) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2006023684) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NY 260892-1) | |
| Enumeration Date | 2007-08-28 |
| Last Update Date | 2020-02-17 |