NPI | 1992792097 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA A65213) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A65213) |
Enumeration Date | 2005-10-04 |
Last Update Date | 2015-09-24 |