| NPI | 1710119953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MT 50222) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301092372) |
| 207X00000X Orthopaedic Surgery (Licence: MT MED-PHYS-LIC-50222) | |
| 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: MT MED-PHYS-LIC-50222) | |
| Enumeration Date | 2009-08-21 |
| Last Update Date | 2022-11-18 |