NPI | 1568698330 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MA 264776) |
Additional Taxonomies | 207XS0106X Orthopaedic Surgery Hand Surgery (Licence: MA 264776) |
207X00000X Orthopaedic Surgery (Licence: NH 18191) | |
Enumeration Date | 2009-06-06 |
Last Update Date | 2017-07-25 |