| NPI | 1386903821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: CA A120958) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A120958) |
| Enumeration Date | 2012-05-03 |
| Last Update Date | 2025-07-14 |