NPI | 1578786075 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: SC 29468) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC 29468) |
Enumeration Date | 2007-04-11 |
Last Update Date | 2022-07-20 |