| NPI | 1073001962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: CA A164530) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A164530) |
| 207X00000X Orthopaedic Surgery (Licence: NV 23680) | |
| Enumeration Date | 2018-04-25 |
| Last Update Date | 2023-07-18 |