| NPI | 1033112875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 94-00425) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: NC 94-00425) |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2021-05-06 |