NPI | 1942628300 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: UT 11641008-1205) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301116837) |
Enumeration Date | 2014-04-02 |
Last Update Date | 2023-06-15 |