| NPI | 1225395783 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: MA 270022) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CT 60004) |
| 207X00000X Orthopaedic Surgery (Licence: MA 270022) | |
| Enumeration Date | 2012-04-20 |
| Last Update Date | 2024-03-06 |