NPI | 1578802401 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: CA A172375) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 264398) |
207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: MA 264398) | |
Enumeration Date | 2013-02-13 |
Last Update Date | 2021-09-02 |