| NPI | 1124039714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ID M-5623) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: ID M-5623) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: ID M-5623) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: ID M-5623) | |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2012-06-12 |