| NPI | 1043369853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101268698) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC 34377) |
| 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: NC 2009-00258) | |
| 207X00000X Orthopaedic Surgery (Licence: NC 2009-00258) | |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2022-07-18 |