| NPI | 1871768788 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC 81581)  | 
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: SC 81581)  | 
| Enumeration Date | 2008-04-23 | 
| Last Update Date | 2024-06-04 |