| NPI | 1659592566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: OR MD162350) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA 60212440) |
| 207X00000X Orthopaedic Surgery (Licence: OR 162350) | |
| 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: OR 162350) | |
| 207X00000X Orthopaedic Surgery (Licence: OR MD162350) | |
| 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: WA 60212440) | |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2024-08-27 |