| NPI | 1225249519 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 070341) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD444890) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: PA MD444890) | |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: GA 070341) | |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2014-11-14 |