| NPI | 1932233715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME94287) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 147448) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2018-01-26 |