| NPI | 1710958723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: MA MA79171) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NH EL12091) |
| 207X00000X Orthopaedic Surgery (Licence: ME MD23728) | |
| 207X00000X Orthopaedic Surgery (Licence: DE C1-0024734) | |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: FL ME121606) | |
| Enumeration Date | 2006-01-28 |
| Last Update Date | 2023-06-30 |