| NPI | 1376518035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: CT 032990) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: CT 032990) |
| 207X00000X Orthopaedic Surgery (Licence: CT 032990) | |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2012-09-10 |