| NPI | 1104473883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: ID M-16740) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 58450) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: AZ 58450) | |
| Enumeration Date | 2019-08-19 |
| Last Update Date | 2022-08-22 |