| NPI | 1922195858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: VA 0101240435) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101240435) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2018-12-14 |