NPI | 1639338890 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD448570) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME151957) |
207X00000X Orthopaedic Surgery (Licence: NJ 25MA09314500) | |
Enumeration Date | 2008-06-03 |
Last Update Date | 2021-11-03 |