| NPI | 1043376890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL OS10817) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: FL OS10817) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: FL OS10817) | |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2012-10-10 |