NPI | 1588606610 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA A65106) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A65106) |
Enumeration Date | 2006-06-12 |
Last Update Date | 2023-10-26 |