NPI | 1629331921 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: OK 33602) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2012017902) |
Enumeration Date | 2012-06-21 |
Last Update Date | 2023-06-22 |