NPI | 1770564718 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA A74745) |
Additional Taxonomies | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: CA A74745) |
Enumeration Date | 2005-11-08 |
Last Update Date | 2021-12-01 |