| NPI | 1043274335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 9800825) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NC 98-00925) |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2014-07-11 |