| NPI | 1982922605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN 54079) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 164508) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: TN 54079) | |
| Enumeration Date | 2010-05-05 |
| Last Update Date | 2024-09-12 |