| NPI | 1760685705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: TX M9603) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX M9603) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: TX M9603) | |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2012-09-27 |