| NPI | 1336303528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: MD D0075667) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT191037) |
| 207X00000X Orthopaedic Surgery (Licence: FL ME112630) | |
| Enumeration Date | 2008-07-16 |
| Last Update Date | 2019-06-26 |