NPI | 1003817693 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: FL ME104071) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A71367) |
207X00000X Orthopaedic Surgery (Licence: FL ME104071) | |
Enumeration Date | 2005-08-03 |
Last Update Date | 2025-03-20 |