| NPI | 1194773689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: KS 0430547) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NE 23606) |
| 207X00000X Orthopaedic Surgery (Licence: IA 38251) | |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: NE 23606) | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2020-11-23 |