| NPI | 1992786115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: UT 346899-1205) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A84788) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: MA 231563) | |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2024-05-20 |