| NPI | 1396055299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: FL ME80065) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GU MC-126) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: GA 75914) | |
| Enumeration Date | 2010-10-14 |
| Last Update Date | 2023-02-07 |