| NPI | 1215468202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME161866) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MS 29607) |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2023-08-03 |