NPI | 1417925462 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A90948) |
Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: CA A90948) |
213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA A90948) | |
Enumeration Date | 2006-03-08 |
Last Update Date | 2021-08-27 |