| NPI | 1518073972 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC 87400) | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: LA 321517) | 
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CT 38363) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: CT 038363) | |
| Enumeration Date | 2006-08-21 | 
| Last Update Date | 2024-11-11 |