| NPI | 1063730786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: SC 38827) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 64008) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: WI 64008) | |
| 207X00000X Orthopaedic Surgery (Licence: NC 164505) | |
| Enumeration Date | 2010-05-05 |
| Last Update Date | 2021-05-27 |