NPI | 1366803843 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: PA OS022100) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA OS022100) |
Enumeration Date | 2016-03-11 |
Last Update Date | 2022-07-15 |