| NPI | 1386835577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: FL ME143594) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX BP1-0029081) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: TX P0804) | |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2020-03-27 |