| NPI | 1952381303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC 51538) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 98-01190) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NC 98-01190) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NC 98-01190) | |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2023-10-02 |