NPI | 1568415206 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX K5283) |
Additional Taxonomies | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: TX K5283) |
Enumeration Date | 2006-05-17 |
Last Update Date | 2023-08-08 |