| NPI | 1518935121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: MI 4301072238) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301072238) |
| 207X00000X Orthopaedic Surgery (Licence: NM MD2004-0315) | |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2023-11-27 |