| NPI | 1730475005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: MO 2018009646) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2018009646) |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2018-08-02 |