| NPI | 1558525733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX T0610) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: FL ME110229) |
| Enumeration Date | 2008-07-16 |
| Last Update Date | 2021-07-19 |