| NPI | 1659344489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: FL ME67747) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME67747) |
| 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: FL ME67747) | |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2021-03-25 |