| NPI | 1548587900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: CO 0054772) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: MO 2019009680) |
| Enumeration Date | 2010-04-26 |
| Last Update Date | 2023-08-29 |