| NPI | 1982083812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: FL ME172780) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 305920) |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2025-07-23 |