NPI | 1811341936 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 35.127505) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KY 48697) |
207X00000X Orthopaedic Surgery (Licence: ZZ 27700) | |
Enumeration Date | 2016-04-14 |
Last Update Date | 2016-11-17 |