NPI | 1508082033 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: WA MD60147145) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD60147145) |
Enumeration Date | 2007-04-17 |
Last Update Date | 2011-10-10 |