| NPI | 1396709879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME135530) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101048438) |
| 207X00000X Orthopaedic Surgery (Licence: MD D0043129) | |
| 207X00000X Orthopaedic Surgery (Licence: DC MD20100) | |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2018-06-21 |