| NPI | 1386805935 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MD D76896) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT193783) |
| 207X00000X Orthopaedic Surgery (Licence: FL ME125262) | |
| Enumeration Date | 2008-06-17 |
| Last Update Date | 2021-07-29 |