| NPI | 1669478178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CT 37370) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD D0085487) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: MD D0085487) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MD D0085487) | |
| Enumeration Date | 2005-06-21 |
| Last Update Date | 2024-08-09 |