| NPI | 1205046992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NH 14840) |
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: MI 4301083570) |
| 207X00000X Orthopaedic Surgery (Licence: FL ME103929) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2021-04-21 |