| NPI | 1437376381 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 65809)  | 
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: GA 65809)  | 
| Enumeration Date | 2007-04-20 | 
| Last Update Date | 2015-08-28 |