| NPI | 1811316847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: UT 11265662-1205) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: UT 11265662-1205) |
| Enumeration Date | 2014-04-07 |
| Last Update Date | 2019-06-12 |