| NPI | 1871792945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 69558) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: TX P1974) |
| 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: TX P1974) | |
| 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: TX P1974) | |
| 207X00000X Orthopaedic Surgery (Licence: TX P1974) | |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2013-08-02 |