| NPI | 1326426925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: MA 1023706) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: MO 2022010975) |
| Enumeration Date | 2015-05-14 |
| Last Update Date | 2026-04-10 |