NPI | 1831233139 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OR MD166627) |
Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: WA MD00047368) |
Enumeration Date | 2007-02-19 |
Last Update Date | 2023-08-23 |