| NPI | 1447693866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX V1824) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: OH 35.133815) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: CA A162485.) | |
| Enumeration Date | 2013-04-16 |
| Last Update Date | 2025-03-06 |