| NPI | 1326044298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: TN 53860) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: VA 0101236252) |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2016-07-08 |