| NPI | 1306004858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: DC MD041985) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD D77087) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: DC MD041985) | |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2024-02-22 |