| NPI | 1972582914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: OH 35.046775) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35-04-6775-K) |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2021-05-26 |