NPI | 1225272396 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: VA 0101258157) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2014004824) |
Enumeration Date | 2009-04-20 |
Last Update Date | 2020-12-10 |