| NPI | 1942657556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: MA 278911) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 267312) |
| 207X00000X Orthopaedic Surgery (Licence: FL ME148525) | |
| Enumeration Date | 2016-05-24 |
| Last Update Date | 2022-08-30 |