| NPI | 1275776551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: OH 35. 122101) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: OH 35. 122101) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: OH 35. 122101) | |
| Enumeration Date | 2009-04-15 |
| Last Update Date | 2018-07-25 |