| NPI | 1528166212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: AZ 29170) |
| Additional Taxonomies | 174400000X Specialist (Licence: AZ 29170) |
| 207X00000X Orthopaedic Surgery (Licence: AZ 29170) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2014-02-07 |