| NPI | 1346210481 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: FL ME90604) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME90604) |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2016-11-10 |