| NPI | 1336149145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: SC 92172) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: DC MD034939) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: PA MD073243L) | |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2024-06-27 |