NPI | 1841646023 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: OR MD208864) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 267352) |
Enumeration Date | 2016-05-06 |
Last Update Date | 2024-05-10 |