NPI | 1639143027 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 108292) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 122354) |
207X00000X Orthopaedic Surgery (Licence: CT 034854) | |
Enumeration Date | 2006-02-14 |
Last Update Date | 2015-06-25 |