| NPI | 1235104704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: FL ME162207) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME162207) |
| 207X00000X Orthopaedic Surgery (Licence: MN 37430) | |
| Enumeration Date | 2006-02-20 |
| Last Update Date | 2025-08-01 |