NPI | 1265473995 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MI 4301078003) |
Additional Taxonomies | 174400000X Specialist (Licence: OH 35087017) |
207X00000X Orthopaedic Surgery (Licence: MI 4301078003) | |
Enumeration Date | 2006-06-10 |
Last Update Date | 2022-11-02 |