| NPI | 1659599264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NE 25574) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME103289) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NE 25574) | |
| Enumeration Date | 2007-04-22 |
| Last Update Date | 2018-04-16 |