NPI | 1073590311 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: PA OS015348) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 34006679S) |
Enumeration Date | 2005-12-28 |
Last Update Date | 2010-12-06 |