| NPI | 1699031369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AL MD.33119) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MS 25533) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: MS 25533) | |
| Enumeration Date | 2012-04-07 |
| Last Update Date | 2021-10-26 |