| NPI | 1922445956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: TX S1469) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 5101020358) |
| Enumeration Date | 2013-05-31 |
| Last Update Date | 2019-08-12 |