| NPI | 1902875156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2020-03620) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME78766) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: FL ME78766) | |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2021-06-14 |