NPI | 1104266444 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ID O-1246) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CT 1.061149-RES) |
Enumeration Date | 2013-07-01 |
Last Update Date | 2023-01-27 |