| NPI | 1427318070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME146962) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: WA MD60738157) |
| Enumeration Date | 2012-05-16 |
| Last Update Date | 2021-05-11 |