| NPI | 1992238257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: CA NA) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA Pending) |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2025-09-29 |