NPI | 1730443417 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KY 53307) |
Additional Taxonomies | 171000000X Military Health Care Provider |
Enumeration Date | 2012-06-27 |
Last Update Date | 2022-03-23 |