| NPI | 1992909543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 74376) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2008-00223) |
| 207X00000X Orthopaedic Surgery (Licence: FL ME134076) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: PA MD431207) | |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2020-11-18 |