| NPI | 1861649303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KS K-04-36058) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY P67001) |
| 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: TX BP10040662) | |
| 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: MI 4301096032) | |
| Enumeration Date | 2008-08-27 |
| Last Update Date | 2019-02-25 |