| NPI | 1952331423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX J1841) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: TX J1841) |
| 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: TX J1841) | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2021-05-28 |