| NPI | 1013925643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: KS 04-27696) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: MO 2007011573) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2022-10-05 |