NPI | 1578544912 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101042392) |
Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: VA 0101042392) |
Enumeration Date | 2005-11-11 |
Last Update Date | 2020-06-10 |