| NPI | 1073833497 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME 124973) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD60545556) |
| Enumeration Date | 2010-06-08 |
| Last Update Date | 2020-03-19 |