NPI | 1467650077 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: MD D75966) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD d75966) |
171000000X Military Health Care Provider | |
Enumeration Date | 2007-07-05 |
Last Update Date | 2025-02-05 |