NPI | 1134116411 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA G40628) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA G40628) |
Enumeration Date | 2005-10-03 |
Last Update Date | 2015-09-24 |