| NPI | 1841637378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: GA 93479) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME140940) |
| 207X00000X Orthopaedic Surgery (Licence: GA 93479) | |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: LA 328483) | |
| Enumeration Date | 2013-05-23 |
| Last Update Date | 2022-12-05 |