| NPI | 1477555423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: TX K5211) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX K5211) |
| 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: TX K5211) | |
| Enumeration Date | 2005-06-02 |
| Last Update Date | 2022-12-23 |