| NPI | 1023010824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: CA G30774) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA G30774) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: ID M3906) | |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2018-05-15 |