| NPI | 1689708596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 35.094078) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: MD D0069815) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: OH 35.094078) | |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2025-04-01 |