| NPI | 1144503483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME156768) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KY R4150) |
| 183500000X Pharmacist (Licence: FL PS43917) | |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: FL ME156768) | |
| Enumeration Date | 2011-09-22 |
| Last Update Date | 2024-05-21 |