| NPI | 1891795985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: MS 26229) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC 833) |
| 207X00000X Orthopaedic Surgery (Licence: MS 26229) | |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2020-10-30 |