NPI | 1134501604 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 101470) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 308423) |
207X00000X Orthopaedic Surgery (Licence: TX T8000) | |
207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: TX T8000) | |
207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: GA 101470) | |
Enumeration Date | 2015-06-22 |
Last Update Date | 2024-10-31 |