| NPI | 1396733341 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: FL ME78419) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME78419) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: FL ME78419) | |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2023-06-05 |