| NPI | 1912068677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: MS 21487) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL TRN9064) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: FL ME106815) | |
| 207X00000X Orthopaedic Surgery (Licence: MS 21487) | |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2017-03-22 |