| NPI | 1518066976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2006-01758) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: OH 35086615) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: NC 009000926) | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2016-04-28 |