| NPI | 1467751685 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2022-02947) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A116333) |
| 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: CA A116333) | |
| Enumeration Date | 2011-03-28 |
| Last Update Date | 2024-01-23 |