NPI | 1043415250 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX R0646) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT184981) |
207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: DE C7-0003655) | |
207X00000X Orthopaedic Surgery (Licence: AZ 41837) | |
208600000X Surgery (Licence: OH 35-095639) | |
Enumeration Date | 2007-06-18 |
Last Update Date | 2017-02-01 |