NPI | 1386693976 |
---|---|
Former Name | LANCE WINTER |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: AZ 4408) |
Additional Taxonomies | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: TX P7228) |
207XX0005X Orthopaedic Surgery Sports Medicine (Licence: FL OS13477) | |
Enumeration Date | 2006-05-09 |
Last Update Date | 2023-01-29 |