| NPI | 1912047945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: VA 0101240556) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME 121785) |
| 207X00000X Orthopaedic Surgery (Licence: VA 0101240556) | |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: VA 0101240556) | |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2021-11-28 |