NPI | 1750817573 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: OH 35.148364) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PR 33974) |
Enumeration Date | 2017-05-11 |
Last Update Date | 2023-10-17 |