| NPI | 1972162626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IA R-11638) |
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: IA R-11638) |
| 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: IA R-11638) | |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: IA R-11638) | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: IA R-11638) | |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: IA R-11638) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: IA R-11638) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: IA R-11638) | |
| Enumeration Date | 2019-06-06 |
| Last Update Date | 2019-06-06 |