| NPI | 1740482850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: GA 070339) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: RI LP01073) |
| 207X00000X Orthopaedic Surgery (Licence: RI 13840) | |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: TX p5595) | |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2014-07-31 |