| NPI | 1326262312 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: GA 78022)  | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 078022)  | 
| 207X00000X Orthopaedic Surgery (Licence: OH 35.091760)  | |
| 207X00000X Orthopaedic Surgery (Licence: TX P5797)  | |
| Enumeration Date | 2007-04-12 | 
| Last Update Date | 2020-09-08 |