| NPI | 1013179548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: FL ME124154) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT192846) |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2023-09-28 |