| NPI | 1306498761 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: TX 47325) | 
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: TX BP10069407) | 
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: FL ME144998) | |
| Enumeration Date | 2019-07-15 | 
| Last Update Date | 2022-04-19 |