| NPI | 1831131390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 17315) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: WI 17315) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: WI 17315) | |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2023-03-07 |