| NPI | 1114366820 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME181130) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AK 133713) |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2026-05-07 |