| NPI | 1629331921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: OK 33602) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2012017902) |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2023-06-22 |