| NPI | 1437238656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: LA 025766) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: LA MD025766) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2013-11-13 |