| NPI | 1790913622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME150465) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: HI MD-16199) |
| 207X00000X Orthopaedic Surgery (Licence: GA 073258) | |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2021-05-27 |