| NPI | 1780634568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ND 14963) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA C152157) |
| 207X00000X Orthopaedic Surgery (Licence: NE 22110) | |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NY 291029) | |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2022-03-31 |