| NPI | 1639552193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: UT 12244788-1204) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA OT016305) |
| 207X00000X Orthopaedic Surgery (Licence: AZ 008115) | |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: UT 12244788-1204) | |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2024-02-22 |