| NPI | 1891795209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WV 23956) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN MD37365) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: WV 23956) | |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: TN MD37365) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: WV 23956) | |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2021-11-17 |