| NPI | 1811094873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: DC MD046595) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A96461) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: CA A96461) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2022-09-19 |