NPI | 1902802903 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CT 037674) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CT 037674) |
Enumeration Date | 2005-06-23 |
Last Update Date | 2022-04-08 |