| NPI | 1932516630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX s7775) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: TX s7775) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: TX s7775) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TX s7775) | |
| 207X00000X Orthopaedic Surgery (Licence: MA 278824) | |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: TX s7775) | |
| 208200000X Plastic Surgery (Licence: TX s7775) | |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: TX s7775) | |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: TX s7775) | |
| 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: TX s7775) | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: TX s7775) | |
| Enumeration Date | 2014-07-15 |
| Last Update Date | 2025-12-09 |