NPI | 1134108558 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NY 249055) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 223417) |
207X00000X Orthopaedic Surgery (Licence: NY 249055) | |
Enumeration Date | 2006-01-13 |
Last Update Date | 2018-04-05 |