| NPI | 1538144209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 200401495) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: NC 200401495) |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2020-06-22 |