NPI | 1073962122 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 92053) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2021-00538) |
Enumeration Date | 2016-06-09 |
Last Update Date | 2022-08-01 |