| NPI | 1255302261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2018009511) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME 62326) |
| Enumeration Date | 2006-01-28 |
| Last Update Date | 2022-09-02 |