NPI | 1700264009 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: DE C2-0013374) |
Additional Taxonomies | 2080S0010X Pediatrics, Sports Medicine (Licence: DE C2-0013374) |
Enumeration Date | 2015-05-07 |
Last Update Date | 2024-11-18 |