NPI | 1063673424 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: LA 204411) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME 101035) |
207X00000X Orthopaedic Surgery (Licence: LA 204411) | |
Enumeration Date | 2008-06-18 |
Last Update Date | 2020-12-11 |