| NPI | 1083825384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: MO 2020014929) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2020014929) |
| 207X00000X Orthopaedic Surgery (Licence: OH 57010712) | |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2022-09-14 |