| NPI | 1629401864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: VT 0420012703) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VT 0420012703) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: VT 0420012703) | |
| Enumeration Date | 2013-08-12 |
| Last Update Date | 2013-10-22 |