| NPI | 1952745796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: TX S3300) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME147027) |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2022-08-30 |