NPI | 1063509180 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: WI 61118-20) |
Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TX S5363) |
Enumeration Date | 2006-10-09 |
Last Update Date | 2024-08-12 |