NPI | 1558758185 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A171072) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 307107) |
207X00000X Orthopaedic Surgery (Licence: ME MD24260) | |
Enumeration Date | 2015-04-21 |
Last Update Date | 2022-05-09 |