| NPI | 1467915181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 80665) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL TRN29415) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: CO DR.0072948) | |
| Enumeration Date | 2019-04-09 |
| Last Update Date | 2025-09-10 |