| NPI | 1093908006 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: OK 30026)  | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX BP1-0017270)  | 
| 207X00000X Orthopaedic Surgery (Licence: TX N5661)  | |
| Enumeration Date | 2007-08-22 | 
| Last Update Date | 2017-01-24 |