NPI | 1760426837 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: CA C37519) |
Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA C37519) |
Enumeration Date | 2006-06-16 |
Last Update Date | 2020-02-17 |