| NPI | 1699066530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: WA MD60226675) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: ZZ 29818) |
| 207X00000X Orthopaedic Surgery (Licence: WA MD60226675) | |
| Enumeration Date | 2011-04-26 |
| Last Update Date | 2012-02-23 |