NPI | 1033439963 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CO DR.0061002) |
Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: WA MD.60650984) |
Enumeration Date | 2010-06-02 |
Last Update Date | 2021-02-12 |