| NPI | 1114127164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX P5502) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: TX P5502) |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2023-03-16 |