NPI | 1679891535 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ND 14841) |
Additional Taxonomies | 174400000X Specialist (Licence: CO 51107) |
207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: IN 02004269A) | |
207X00000X Orthopaedic Surgery (Licence: IN 02004269A) | |
Enumeration Date | 2010-05-17 |
Last Update Date | 2024-09-11 |