| NPI | 1619181856 | 
|---|---|
| Professional Name | JESSE WILD | 
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: AZ 41165) | 
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: AZ 41165) | 
| 207X00000X Orthopaedic Surgery (Licence: AZ 41165) | |
| Enumeration Date | 2007-05-09 | 
| Last Update Date | 2024-07-19 |