NPI | 1831366897 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: OH 35124094) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT192601) |
207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: KY TP955) | |
Enumeration Date | 2008-05-09 |
Last Update Date | 2022-01-27 |