| NPI | 1437577590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KY 54088) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA 162981) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: KY 54088) | |
| Enumeration Date | 2014-04-04 |
| Last Update Date | 2024-10-24 |