| NPI | 1992764203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: OH 35.054573) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35-05-4573) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2024-06-12 |