| NPI | 1730308552 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: NV 29092) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NV 29092) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2026-03-10 |