| NPI | 1144262049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MD D0015828) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: MD D0015828) |
| 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: MD D0015828) | |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2009-11-23 |