NPI | 1376669572 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA A62553) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A62553) |
Enumeration Date | 2007-03-21 |
Last Update Date | 2020-01-29 |