NPI | 1306852900 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TX H8823) |
Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NM 2000-286) |
Enumeration Date | 2006-08-01 |
Last Update Date | 2025-05-21 |