| NPI | 1376629154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX E2501) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: TX E2501) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TX E2501) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: TX E2501) | |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2011-07-21 |