NPI | 1376863456 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2015-00253) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA OT013666) |
207X00000X Orthopaedic Surgery (Licence: TN 2806) | |
207X00000X Orthopaedic Surgery (Licence: PA OS017457) | |
Enumeration Date | 2010-06-11 |
Last Update Date | 2015-07-08 |