| NPI | 1669961702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: PA MD480695) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD480695) |
| 207X00000X Orthopaedic Surgery (Licence: MD D0099579) | |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: MD D0099579) | |
| Enumeration Date | 2018-05-03 |
| Last Update Date | 2024-04-30 |