| NPI | 1710983499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: VA 0101243628) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: PA MD030836E) |
| 174400000X Specialist (Licence: PA MD030836E) | |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2022-01-26 |