| NPI | 1255312435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL OS0004785) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: FL OS4785) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: FL OS4785) | |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: FL OS4785) | |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2013-12-12 |