| NPI | 1679838718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: GA 80646) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2017-00542) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NC 2017-00542) | |
| Enumeration Date | 2012-07-04 |
| Last Update Date | 2018-07-09 |