| NPI | 1730404062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NC 2020-02769) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2020-02769) |
| Enumeration Date | 2010-03-30 |
| Last Update Date | 2021-06-02 |