NPI | 1548219702 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD R122529) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD R122529) |
Enumeration Date | 2006-05-08 |
Last Update Date | 2007-11-21 |