NPI | 1639794811 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX V6047) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 11997) |
Enumeration Date | 2020-06-12 |
Last Update Date | 2025-07-21 |