NPI | 1912338112 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: PA MT205356) |
Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: DE C7-0005493) |
Enumeration Date | 2013-12-13 |
Last Update Date | 2013-12-13 |