| NPI | 1376962530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: TX S5783) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX S5783) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2020-08-13 |