| NPI | 1033258736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PR 19799) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: SC 51836) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: SC 51836) | |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2018-03-17 |