| NPI | 1184639577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: CO 51419) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: FL ME95042) |
| 207X00000X Orthopaedic Surgery (Licence: TX M7362) | |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: TX M7362) | |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2013-07-12 |