NPI | 1700173424 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD60697627) |
Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: WA MD60697627) |
Enumeration Date | 2011-07-01 |
Last Update Date | 2022-02-02 |