| NPI | 1912138371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NE 28122) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NE 28122) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: NE 28122) | |
| Enumeration Date | 2009-08-03 |
| Last Update Date | 2021-03-02 |