NPI | 1609879535 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA OS010707L) |
Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: PA OS010707L) |
Enumeration Date | 2005-05-24 |
Last Update Date | 2019-10-31 |