| NPI | 1821029562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: CO 40870) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AK 5866) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2022-01-14 |