NPI | 1669478178 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MD D0085487) |
Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: MD D0085487) |
207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MD D0085487) | |
Enumeration Date | 2005-06-21 |
Last Update Date | 2018-10-01 |