| NPI | 1265462337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 38392) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: CA G88110) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: WI 38392) | |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2023-06-16 |