NPI | 1205395134 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: TX V7496) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX V7496) |
207X00000X Orthopaedic Surgery (Licence: OH 35.150048) | |
Enumeration Date | 2019-03-19 |
Last Update Date | 2025-08-15 |