| NPI | 1750644290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: SC 83210) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 252622) |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2022-04-27 |