NPI | 1447614821 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2022019105) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 62684) |
Enumeration Date | 2016-04-11 |
Last Update Date | 2022-09-22 |