NPI | 1154369460 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA G863450) |
Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA G863450) |
Enumeration Date | 2006-06-02 |
Last Update Date | 2008-10-27 |