| NPI | 1932199130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NH 15105) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: MA 202356) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: TX E7115) | |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2012-07-23 |