| NPI | 1215948807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ID M-6903) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: ID M-6903) |
| 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: ID M-6903) | |
| 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: ID M-6903) | |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2011-02-15 |