| NPI | 1356316178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: VA 0101036792) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101036792) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: VA 0101036792) | |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2012-04-13 |