| NPI | 1578525051 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NH 10418) | 
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NH 10418) | 
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NH 10418) | |
| Enumeration Date | 2006-04-03 | 
| Last Update Date | 2011-10-07 |