| NPI | 1851812937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: WI 82150) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NE 8109) |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2023-08-18 |