| NPI | 1447256979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CO 30838) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: CO 30838) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CO 30838) | |
| Enumeration Date | 2005-06-21 |
| Last Update Date | 2011-09-09 |