| NPI | 1124162789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: FL ME 116897) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME116897) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2024-02-21 |