| NPI | 1336103282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: OH 35.079734) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35 . 079734) |
| 207X00000X Orthopaedic Surgery (Licence: FL ME101281) | |
| Enumeration Date | 2006-04-15 |
| Last Update Date | 2024-04-24 |