NPI | 1881011351 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: TX S0896) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX S0896) |
Enumeration Date | 2014-03-23 |
Last Update Date | 2020-09-29 |