NPI | 1700889540 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: FL ME68918) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 047143) |
207X00000X Orthopaedic Surgery (Licence: FL ME68918) | |
207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: GA 047143) | |
Enumeration Date | 2005-05-24 |
Last Update Date | 2021-11-22 |