| NPI | 1376548065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME82208) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: FL ME82208) |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2020-07-10 |