| NPI | 1457356701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL 593072246) |
| Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: FL 593072246) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: FL 593072246) | |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: FL 593072246) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: FL 593072246) | |
| Enumeration Date | 2005-06-14 |
| Last Update Date | 2012-01-12 |