| NPI | 1386940450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: TX R7996) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A116538) |
| 207X00000X Orthopaedic Surgery (Licence: FL ME116497) | |
| Enumeration Date | 2011-02-07 |
| Last Update Date | 2019-11-12 |