| NPI | 1205917374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME96185) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2013-00103) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2022-06-30 |