| NPI | 1942400536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: WA MD60261135) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD60261135) |
| 207X00000X Orthopaedic Surgery (Licence: TX BP10024992) | |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2019-07-16 |