NPI | 1730269341 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AK 7100) |
Additional Taxonomies | 171000000X Military Health Care Provider (Licence: TN 27194) |
Enumeration Date | 2006-10-17 |
Last Update Date | 2022-05-09 |