| NPI | 1275516486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CO 47920) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: NC 2005-00070) |
| 207X00000X Orthopaedic Surgery (Licence: WA MD00046367) | |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: WA MD00046367) | |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: CO 47920) | |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2012-10-23 |