| NPI | 1982675799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: CA C175024) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2010-00683) |
| 207X00000X Orthopaedic Surgery (Licence: IN 01050473A) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA C175024) | |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2025-12-05 |