| NPI | 1184690489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: TX R0524) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX R0524) |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2017-05-10 |