| NPI | 1760474266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: UT 1815511205) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: UT 181551-1205) |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2020-05-07 |