| NPI | 1801842505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CT 37308) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: CT 37308) |
| 207X00000X Orthopaedic Surgery (Licence: MA 71499) | |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2019-12-04 |