NPI | 1407152325 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NY 285108) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 201500977) |
Enumeration Date | 2011-02-10 |
Last Update Date | 2017-03-26 |