NPI | 1972699213 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA A43148) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A43148) |
Enumeration Date | 2006-10-05 |
Last Update Date | 2021-02-07 |