| NPI | 1952374498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: FL ME102967) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC 22674) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: MI 4301102465) | |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2020-06-04 |