| NPI | 1366889545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IL 036161715) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ 25ma10294700) |
| 208600000X Surgery (Licence: FL ME141153) | |
| 208C00000X Colon & Rectal Surgery (Licence: FL ME141153) | |
| Enumeration Date | 2013-05-29 |
| Last Update Date | 2022-12-22 |