NPI | 1629043005 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD429053) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WV 20644) |
207X00000X Orthopaedic Surgery (Licence: OH 35083055) | |
Enumeration Date | 2006-02-21 |
Last Update Date | 2022-04-07 |