| NPI | 1346230265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME70142) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: FL ME70142) |
| 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: FL ME70142) | |
| Enumeration Date | 2005-10-22 |
| Last Update Date | 2018-01-08 |