NPI | 1992064026 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: LA MD.308290) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MS 24984) |
Enumeration Date | 2012-05-09 |
Last Update Date | 2018-07-18 |