| NPI | 1457622631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IA 44506) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME128044) |
| Enumeration Date | 2012-01-20 |
| Last Update Date | 2023-01-17 |