NPI | 1013039759 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: MI 5101015359) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 9041) |
207X00000X Orthopaedic Surgery (Licence: WV 2233) | |
Enumeration Date | 2007-04-04 |
Last Update Date | 2016-08-03 |