| NPI | 1962409417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CT 26297) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CT 026297) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: CT 26297) | |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2021-07-24 |