| NPI | 1538665443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MA 1013971) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: WA OP61565404) |
| Enumeration Date | 2018-04-01 |
| Last Update Date | 2024-08-16 |