NPI | 1336594621 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: VA 0101272483) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD D91528) |
207X00000X Orthopaedic Surgery (Licence: WV 31374) | |
Enumeration Date | 2016-04-25 |
Last Update Date | 2024-12-30 |