| NPI | 1205090297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: SD 13145) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IA 36706) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: IA MD-36706) | |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: NE 31630) | |
| Enumeration Date | 2008-07-18 |
| Last Update Date | 2025-12-10 |