NPI | 1639515984 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: LA 320551) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA L-255690) |
Enumeration Date | 2013-05-14 |
Last Update Date | 2021-06-21 |