| NPI | 1558369058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: TX L4010) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX L4010) |
| 207X00000X Orthopaedic Surgery (Licence: TX L4010) | |
| 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: TX L4010) | |
| 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: TX L4010) | |
| 207XS0106X Orthopaedic Surgery Hand Surgery (Licence: TX L4010) | |
| 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: TX L4010) | |
| 207XP3100X Orthopaedic Surgery Pediatric Orthopaedic Surgery (Licence: TX L4010) | |
| 2086S0127X Surgery Trauma Surgery (Licence: TX L4010) | |
| 208600000X Surgery (Licence: TX L4010) | |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2017-03-07 |