| NPI | 1063901023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: GA 101390) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME163050) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: FL ME163050) | |
| Enumeration Date | 2018-05-05 |
| Last Update Date | 2025-02-10 |