| NPI | 1548380850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: SC 29484) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN 39782) |
| 207X00000X Orthopaedic Surgery (Licence: TX M9734) | |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2021-06-18 |