| NPI | 1043918824 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID BLAEUER Executive Director 302-731-2888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine | |
| 213E00000X Podiatrist | |
| Enumeration Date | 2023-02-21 |
| Last Update Date | 2023-02-21 |