| NPI | 1720176126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: SC 25335) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD D0067318) |
| 207X00000X Orthopaedic Surgery (Licence: SC 25335) | |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2020-11-18 |