| NPI | 1629039722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: LA MD.202809) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME91940) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2021-06-14 |