| NPI | 1407143381 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: GA 069783) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 4879) |
| 207X00000X Orthopaedic Surgery (Licence: GA 069783) | |
| Enumeration Date | 2011-06-29 |
| Last Update Date | 2017-10-31 |