| NPI | 1578552378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 38689) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: WI 38689) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: WI 38689) | |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2010-08-13 |