NPI | 1083842371 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A155743) |
Additional Taxonomies | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: CA A155743) |
Enumeration Date | 2009-06-25 |
Last Update Date | 2024-08-02 |