| NPI | 1316353949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: CA A168934) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: CO 62501) |
| 207X00000X Orthopaedic Surgery (Licence: MN 59334) | |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2021-07-16 |