| NPI | 1548232085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: OH 35.148829) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CT 44950) |
| 207X00000X Orthopaedic Surgery (Licence: OH 35.148829) | |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: CT 44950) | |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2023-08-13 |