| NPI | 1881895316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: CA A108380) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL TRN6888) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2023-10-31 |