| NPI | 1326021288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 28119) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 29236-20) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: NC 28119) | |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: WI 29236-20) | |
| Enumeration Date | 2005-11-23 |
| Last Update Date | 2023-03-10 |