| NPI | 1962853853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: LA 324029) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: MO 2021044792) |
| 207X00000X Orthopaedic Surgery (Licence: MO 2021044792) | |
| Enumeration Date | 2016-06-22 |
| Last Update Date | 2023-09-22 |