| NPI | 1639564065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: OR MD203653) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OR MD203653) |
| 207X00000X Orthopaedic Surgery (Licence: TN 61038) | |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2021-06-05 |