| NPI | 1104323286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME181577) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD D0101580) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MD D0101580) | |
| Enumeration Date | 2018-04-06 |
| Last Update Date | 2026-08-27 |