NPI | 1710542667 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101285323) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD61526149) |
207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: WA MD61526149) | |
207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: VA 0101285323) | |
Enumeration Date | 2019-05-07 |
Last Update Date | 2025-10-03 |