NPI | 1740660430 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME150934) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL TRN21698) |
207X00000X Orthopaedic Surgery (Licence: NC 2020-00293) | |
Enumeration Date | 2015-06-08 |
Last Update Date | 2021-08-30 |