NPI | 1710988449 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: AZ 10715) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 10715) |
207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: AZ 10715) | |
Enumeration Date | 2005-08-03 |
Last Update Date | 2014-02-11 |