| NPI | 1710279724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: OK 32931) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME127315) |
| Enumeration Date | 2011-05-09 |
| Last Update Date | 2022-07-21 |