NPI | 1790211696 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A158146) |
Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: CA A158146) |
207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA A158146) | |
Enumeration Date | 2017-05-11 |
Last Update Date | 2024-06-07 |