| NPI | 1154396570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: WA MD00039438) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD00039438) |
| 207X00000X Orthopaedic Surgery (Licence: ME MD23765) | |
| Enumeration Date | 2006-02-20 |
| Last Update Date | 2023-06-30 |