NPI | 1912113515 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TX M5362) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX M5362) |
Enumeration Date | 2007-05-14 |
Last Update Date | 2022-08-18 |