| NPI | 1639551880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 4301509590) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2015020396) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: NV 21959) | |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: CA 176232) | |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2024-08-20 |