| NPI | 1427267749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: WA MD.MD.00049387) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD00049387) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2026-07-21 |