NPI | 1023409471 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NV 21205) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NV 21205) |
Enumeration Date | 2015-02-06 |
Last Update Date | 2021-12-20 |