NPI | 1487394391 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: IA MD-53747) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IA MD-53747) |
207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: IA MD-53747) | |
Enumeration Date | 2022-03-30 |
Last Update Date | 2025-08-26 |