| NPI | 1851339550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: MD D0058574) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD D0058574) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: MD D0058574) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MD D0058574) | |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2016-04-06 |