NPI | 1831851807 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MD C0008198) |
Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MD C0008198) |
363AS0400X Physician Assistant, Surgical | |
Enumeration Date | 2021-10-07 |
Last Update Date | 2022-12-12 |