| NPI | 1528269735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: OR MD150842) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD436657) |
| 207X00000X Orthopaedic Surgery (Licence: OH 57008995) | |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2022-10-05 |