NPI | 1003811811 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 132580) |
Additional Taxonomies | 225000000X Orthotic Fitter (Licence: NY 132580) |
Enumeration Date | 2005-06-17 |
Last Update Date | 2011-06-06 |