| NPI | 1023350113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: FL ME152894) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME152894) |
| 207X00000X Orthopaedic Surgery (Licence: CA A154107) | |
| 207X00000X Orthopaedic Surgery (Licence: NJ 25MA10638900) | |
| Enumeration Date | 2013-03-26 |
| Last Update Date | 2024-02-29 |