| NPI | 1124405568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 92130) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: FL ME150330) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: GA 92130) | |
| 207X00000X Orthopaedic Surgery (Licence: FL ME150330) | |
| Enumeration Date | 2015-05-06 |
| Last Update Date | 2022-07-25 |