NPI | 1013203470 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2018-02063) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 269962) |
208600000X Surgery (Licence: NC 173880) | |
Enumeration Date | 2011-06-23 |
Last Update Date | 2020-10-25 |