NPI | 1790070035 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: DE C2-0000458) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA OT014316) |
Enumeration Date | 2011-06-15 |
Last Update Date | 2022-02-15 |