| NPI | 1649433137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: AZ 46568) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY N/A) |
| 207X00000X Orthopaedic Surgery (Licence: AZ 46568) | |
| Enumeration Date | 2008-07-06 |
| Last Update Date | 2019-04-10 |