NPI | 1821057621 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WV 19175) |
Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: WV 19175) |
207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: WV 19175) | |
Enumeration Date | 2006-03-21 |
Last Update Date | 2021-11-19 |