NPI | 1336124890 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 5101010937) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WY 7949A) |
Enumeration Date | 2005-12-07 |
Last Update Date | 2021-02-01 |