NPI | 1720192388 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OK 3922) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 30805) |
207X00000X Orthopaedic Surgery (Licence: FL OS7100) | |
207X00000X Orthopaedic Surgery (Licence: ME 845) | |
Enumeration Date | 2006-08-19 |
Last Update Date | 2018-01-22 |