NPI | 1205836574 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AL 10008) |
Additional Taxonomies | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: AL 10008) |
Enumeration Date | 2005-07-28 |
Last Update Date | 2012-10-10 |