NPI | 1629496237 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 4301502153) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 297701) |
Enumeration Date | 2014-04-01 |
Last Update Date | 2020-07-21 |