NPI | 1396162673 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: OR MD206048) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD60932486) |
207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: WA MD60932486) | |
Enumeration Date | 2014-03-24 |
Last Update Date | 2021-10-24 |