| NPI | 1205096369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: NE 27897) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NE 27897) |
| 207X00000X Orthopaedic Surgery (Licence: OK 26328) | |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: IA MD-41772) | |
| 207X00000X Orthopaedic Surgery (Licence: IA MD-41772) | |
| Enumeration Date | 2008-06-12 |
| Last Update Date | 2022-06-23 |