| NPI | 1316945876 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ID M-10680)  | 
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: ID M-10680)  | 
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: ID M-10680)  | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: ID M-10680)  | |
| Enumeration Date | 2005-07-08 | 
| Last Update Date | 2023-12-22 |