NPI | 1336303528 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: MD D0075667) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT191037) |
207X00000X Orthopaedic Surgery (Licence: FL ME112630) | |
Enumeration Date | 2008-07-16 |
Last Update Date | 2019-06-26 |