NPI | 1366430407 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: FL ME60369) |
Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: FL ME60369) |
207X00000X Orthopaedic Surgery (Licence: FL ME60639) | |
Enumeration Date | 2005-10-12 |
Last Update Date | 2023-10-25 |