| NPI | 1568755486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AL MD.35169) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207X00000X Orthopaedic Surgery (Licence: FL ME131424) | |
| Enumeration Date | 2011-05-25 |
| Last Update Date | 2019-07-02 |