| NPI | 1568859700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: SC 85884) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2020010472) |
| 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: MO 2020010472) | |
| Enumeration Date | 2015-04-24 |
| Last Update Date | 2021-08-25 |