| NPI | 1982701041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2002023151) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101254404) |
| 207X00000X Orthopaedic Surgery (Licence: WI 62544) | |
| 207X00000X Orthopaedic Surgery (Licence: FL ME100746) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-03-16 |