| NPI | 1831298819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: SC 33332) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NE 23703) |
| 207X00000X Orthopaedic Surgery (Licence: NC 2009-01385) | |
| 207X00000X Orthopaedic Surgery (Licence: MA 250286) | |
| 207X00000X Orthopaedic Surgery (Licence: SC 33332) | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2016-07-26 |