NPI | 1033201058 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: FL OS13249) |
Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA 20A9582) |
Enumeration Date | 2006-09-28 |
Last Update Date | 2016-03-15 |