NPI | 1427232362 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: KY 46083) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 002764) |
207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: OH 35121674) | |
Enumeration Date | 2007-12-27 |
Last Update Date | 2013-11-08 |