| NPI | 1598748725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: UT 6475000-1205) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2005-01034) |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2021-11-23 |