| NPI | 1205286457 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME168362) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT210976) |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2024-09-26 |