NPI | 1316218431 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: CA A116828) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A116828) |
Enumeration Date | 2012-01-20 |
Last Update Date | 2017-12-19 |