NPI | 1619242195 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: PA OS019359) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA OS019359) |
Enumeration Date | 2012-03-15 |
Last Update Date | 2024-08-20 |