| NPI | 1295937928 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: MS 21148) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MS T1810) |
| 207X00000X Orthopaedic Surgery (Licence: NC 2010-00801) | |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2011-07-27 |