NPI | 1346465119 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: UT 8228386-1205) |
Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: MO 2011001617) |
Enumeration Date | 2007-04-16 |
Last Update Date | 2021-09-23 |