NPI | 1447041512 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: WA MD61667996) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD61667996) |
207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: WA MD61667996) | |
Enumeration Date | 2025-05-16 |
Last Update Date | 2025-05-16 |