| NPI | 1669736989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: HI 19711) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT202409) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: HI 19711) | |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: IL 125.069762) | |
| Enumeration Date | 2012-07-02 |
| Last Update Date | 2023-12-03 |