| NPI | 1174733125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: SC 27197) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC 27197) |
| 207X00000X Orthopaedic Surgery (Licence: FL ME103720) | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2021-02-15 |