NPI | 1114451192 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: PA MD481773) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD481773) |
Enumeration Date | 2017-04-17 |
Last Update Date | 2024-08-20 |