| NPI | 1609015452 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: FL ME103748) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 302025) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NY 302025) | |
| Enumeration Date | 2009-02-18 |
| Last Update Date | 2024-07-01 |