| NPI | 1326215518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101255929) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA UID441344) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: VA 0101255929) | |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2023-11-07 |