| NPI | 1205051430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: AZ 42724) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MS 19568) |
| 207X00000X Orthopaedic Surgery (Licence: OH 35. 093195) | |
| 207X00000X Orthopaedic Surgery (Licence: AZ 42724) | |
| Enumeration Date | 2007-04-14 |
| Last Update Date | 2022-07-25 |