NPI | 1134123656 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CT 049867) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 261498-1) |
207X00000X Orthopaedic Surgery (Licence: IL 036060200) | |
Enumeration Date | 2005-06-13 |
Last Update Date | 2013-09-16 |