| NPI | 1326099698 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: AZ 005334)  | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 005334)  | 
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: AZ 005334)  | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: AZ 005334)  | |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: AZ 005334)  | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: AZ 005334)  | |
| Enumeration Date | 2006-05-12 | 
| Last Update Date | 2014-02-10 |