| NPI | 1629420138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0102207145) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA OS019314) |
| 207X00000X Orthopaedic Surgery (Licence: PA OT016983) | |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: VA 0102207145) | |
| Enumeration Date | 2016-07-08 |
| Last Update Date | 2022-11-15 |