NPI | 1043348378 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CA g081777) |
Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: CA go81777) |
2086S0102X Surgery, Surgical Critical Care (Licence: CA g081777) | |
Enumeration Date | 2007-02-28 |
Last Update Date | 2010-04-16 |