| NPI | 1619983046 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: MA 254861) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NH 10453) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2013-10-24 |