NPI | 1063603454 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CO TDP.0001014) |
Additional Taxonomies | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: CO TDP.0001014) |
207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: CO TDP.0001014) | |
Enumeration Date | 2007-08-09 |
Last Update Date | 2025-02-11 |