| NPI | 1689661787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 044545) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: GA 044545) |
| 207X00000X Orthopaedic Surgery (Licence: TN DO01978) | |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2017-01-25 |