| NPI | 1255363362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: PA md020937e) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: PA md020937e) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: PA md020937e) | |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2009-04-08 |