| NPI | 1700052123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AZ 42034) |
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: AZ 42034) |
| 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: AZ 42034) | |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: AZ 42034) | |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: AZ 42034) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: AZ 42034) | |
| Enumeration Date | 2008-05-06 |
| Last Update Date | 2015-08-11 |