| NPI | 1215198007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: AL 34176) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WV 24565) |
| 208600000X Surgery (Licence: AL R9794) | |
| 174400000X Specialist (Licence: WV 24565) | |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: OH 35.123634) | |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2015-10-13 |