| NPI | 1487966560 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: PA OS021446) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL OS13580) |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2022-07-21 |