NPI | 1639162225 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: MO R9F75) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO R9F75) |
Enumeration Date | 2005-08-30 |
Last Update Date | 2019-09-09 |