| NPI | 1780175281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IA R-11164) |
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery Pediatric Orthopaedic Surgery (Licence: IA R-11164) |
| 207XS0106X Orthopaedic Surgery Hand Surgery (Licence: IA R-11164) | |
| 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: IA R-11164) | |
| 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: IA R-11164) | |
| 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: IA R-11164) | |
| 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: IA R-11164) | |
| 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: IA R-11164) | |
| Enumeration Date | 2018-05-21 |
| Last Update Date | 2018-05-21 |