| NPI | 1578649646 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: FL ME115417) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: HI 12441) |
| 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: FL ME115417) | |
| 208200000X Plastic Surgery (Licence: FL ME115417) | |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2017-09-21 |