| NPI | 1922392992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: SC 33605) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC 33605) |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2023-03-10 |