| NPI | 1326097726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME154727) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: MO 106543) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2022-02-10 |