| NPI | 1861408312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: OR MD23753) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OR MD23753) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: OR MD23753) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2011-10-19 |