| NPI | 1265589774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME151430) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 40469) |
| 207X00000X Orthopaedic Surgery (Licence: VA 0101241018) | |
| 207X00000X Orthopaedic Surgery (Licence: CT 047438) | |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2022-06-10 |