| NPI | 1326427444 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: CA A171604) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 60818) |
| Enumeration Date | 2015-05-21 |
| Last Update Date | 2021-09-24 |