| NPI | 1811987571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: CA A86534) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: ME 016737) |
| 207X00000X Orthopaedic Surgery (Licence: CA A86534) | |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2024-01-18 |