| NPI | 1487002184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 85347) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME154088) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: GA 85347) | |
| Enumeration Date | 2016-06-03 |
| Last Update Date | 2023-07-31 |