NPI | 1063892560 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NY 310012) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OK 5931) |
207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NV DO2666) | |
Enumeration Date | 2015-06-01 |
Last Update Date | 2023-12-07 |