| NPI | 1013177609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: AR AR E-8683) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME114728) |
| Enumeration Date | 2008-06-17 |
| Last Update Date | 2018-03-28 |