| NPI | 1649241696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: TX P8710) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX P8710) |
| Enumeration Date | 2006-01-29 |
| Last Update Date | 2020-01-14 |