| NPI | 1609214246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: FL ME134760) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ R73929) |
| Enumeration Date | 2013-06-05 |
| Last Update Date | 2023-05-10 |