| NPI | 1871856740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NV DO2289) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 5101020103) |
| Enumeration Date | 2012-06-16 |
| Last Update Date | 2018-07-02 |