NPI | 1952831927 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC 90680) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD476492) |
207X00000X Orthopaedic Surgery (Licence: MI 4301112363) | |
Enumeration Date | 2017-06-13 |
Last Update Date | 2024-12-11 |