| NPI | 1508246083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: FL ME143826) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IL 125066429) |
| 207X00000X Orthopaedic Surgery (Licence: FL ME143826) | |
| Enumeration Date | 2015-06-01 |
| Last Update Date | 2024-10-22 |