| NPI | 1750842357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: TX u9238) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX U9238) |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2025-05-05 |