| NPI | 1669607172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: ID M-10673) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: OR MD151135) |
| Enumeration Date | 2009-05-28 |
| Last Update Date | 2013-09-17 |