NPI | 1679838718 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: GA 80646) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2017-00542) |
207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NC 2017-00542) | |
Enumeration Date | 2012-07-04 |
Last Update Date | 2018-07-09 |