| NPI | 1720036270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: NV 11796) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NV 11796) |
| 207X00000X Orthopaedic Surgery (Licence: CA A94028) | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2021-12-22 |