| NPI | 1316243538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD61143141) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: MD D77843) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: FL ME130258) | |
| Enumeration Date | 2011-02-04 |
| Last Update Date | 2021-12-02 |