| NPI | 1770588477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: FL OS4860) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL OS4860) |
| 207X00000X Orthopaedic Surgery (Licence: PA OS014568) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: PA OS014568) | |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2016-06-30 |