| NPI | 1780669432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: SC 91839) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2009-00015) |
| 207X00000X Orthopaedic Surgery (Licence: NY 226170-1) | |
| 207X00000X Orthopaedic Surgery (Licence: VA 0101257790) | |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2024-05-07 |