NPI | 1982852679 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 85878) |
Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TX S5498) |
Enumeration Date | 2008-09-05 |
Last Update Date | 2025-09-05 |