NPI | 1639483522 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME159674) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CT 052337) |
207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: CT 052337) | |
207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: CT 052337) | |
Enumeration Date | 2010-08-03 |
Last Update Date | 2023-03-03 |