| NPI | 1427058536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OR MD22211) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: OR MD22211) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: OR MD22211) | |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2020-07-27 |