NPI | 1649270059 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TX E4316) |
Additional Taxonomies | 174400000X Specialist (Licence: TX E4316) |
Enumeration Date | 2005-07-28 |
Last Update Date | 2023-07-22 |