| NPI | 1922029099 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: SC 19449) | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC 19449) | 
| Enumeration Date | 2006-07-22 | 
| Last Update Date | 2016-07-01 |