| NPI | 1487070397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 90738) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2020-01095) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: GA 90738) | |
| Enumeration Date | 2014-03-16 |
| Last Update Date | 2025-06-11 |