| NPI | 1306340872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AZ 73224) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC RTL23-1217) |
| 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: AZ 73224) | |
| 207X00000X Orthopaedic Surgery (Licence: IL 125072256) | |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2024-08-01 |