| NPI | 1861489122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: OH 35072139) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35072139) |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2023-11-03 |