NPI | 1790051084 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: OR MD188610) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A148264) |
Enumeration Date | 2012-03-30 |
Last Update Date | 2024-08-21 |