| NPI | 1497983761 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: CA A136753) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2014-00906) |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2025-01-24 |