| NPI | 1831517192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2020-00824) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC 201285) |
| 207X00000X Orthopaedic Surgery (Licence: VA 0101266465) | |
| 207X00000X Orthopaedic Surgery (Licence: MD D86954) | |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: MD D86954) | |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: VA 0101266465) | |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2024-12-17 |