NPI | 1942413828 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: OH 35.095553) |
Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MI 4301095810) |
Enumeration Date | 2007-05-08 |
Last Update Date | 2011-05-26 |