| NPI | 1770555393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: CA C172740) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: NV 21229) |
| 207X00000X Orthopaedic Surgery (Licence: CA C172740) | |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2022-04-14 |