| NPI | 1720050156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: AZ 32496) |
| Additional Taxonomies | 174400000X Specialist (Licence: AZ 32496) |
| 207X00000X Orthopaedic Surgery (Licence: AZ 32496) | |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2016-09-02 |