NPI | 1629279393 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: TX P8657) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NE 24117) |
207X00000X Orthopaedic Surgery (Licence: MA 242841) | |
207X00000X Orthopaedic Surgery (Licence: CO CDR.0001848) | |
Enumeration Date | 2007-05-30 |
Last Update Date | 2023-04-13 |