| NPI | 1023065240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: PA MD484967) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 9900595) |
| 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: NC 9900595) | |
| 207X00000X Orthopaedic Surgery (Licence: PA MD4844967) | |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2024-08-28 |