| NPI | 1033149067 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME123773) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NE 22468) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2025-01-02 |