NPI | 1932996949 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: PA MD487782) |
Additional Taxonomies | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: PA MD487782) |
207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: PA MD487782) | |
Enumeration Date | 2025-04-22 |
Last Update Date | 2025-04-22 |