NPI | 1215424452 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA A163982) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A163982) |
207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CO DR.0070547) | |
Enumeration Date | 2018-04-13 |
Last Update Date | 2024-09-19 |