NPI | 1124050653 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A97281) |
Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MA 227009) |
Enumeration Date | 2006-07-07 |
Last Update Date | 2021-12-09 |