| NPI | 1003861931 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: CO 36392) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CO 36392) |
| 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: CO 36392) | |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2013-12-19 |