| NPI | 1922103373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101251415) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NE 21764) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: VA 0101251415) | |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2020-09-02 |