| NPI | 1255741898 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME151671) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: AL MD.41070) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: FL ME151671) | |
| Enumeration Date | 2014-05-05 |
| Last Update Date | 2026-01-12 |