NPI | 1700022043 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MA 249143) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT185337) |
207X00000X Orthopaedic Surgery (Licence: NJ 25MA09198900) | |
Enumeration Date | 2008-12-16 |
Last Update Date | 2013-05-17 |