NPI | 1366837304 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: CA A177636) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 210028) |
207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: UT 12247277-1205) | |
Enumeration Date | 2015-04-06 |
Last Update Date | 2022-12-07 |