| NPI | 1184981789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: FL ME149424) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: PA MD461524) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NJ 25MA10403300) | |
| Enumeration Date | 2012-04-19 |
| Last Update Date | 2021-11-10 |