| NPI | 1881707974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MA 236459) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CO 44608) |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: MA 236459) | |
| 207X00000X Orthopaedic Surgery (Licence: MA 236459) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: MA 236459) | |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2012-12-05 |