| NPI | 1386937001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2020-01441) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 72171) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: MA 269712) | |
| Enumeration Date | 2011-05-27 |
| Last Update Date | 2020-05-08 |