| NPI | 1225241060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME165184) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KY 45991) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: FL ME165184) | |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2024-09-05 |