| NPI | 1811253347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: FL ME137456) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 62183) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: MN 62183) | |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2018-10-15 |