NPI | 1669448403 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 5101019062) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN DO0000001649) |
207X00000X Orthopaedic Surgery (Licence: GA 043790) | |
207X00000X Orthopaedic Surgery (Licence: NY 266664) | |
Enumeration Date | 2006-02-23 |
Last Update Date | 2020-08-06 |