| NPI | 1023403789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: KS 04-43440) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KS 04-43440) |
| 207X00000X Orthopaedic Surgery (Licence: UT 12208319-1205) | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: UT 12208319-1205) | |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: UT 12208319-1205) | |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2022-11-02 |