| NPI | 1265895676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME156740) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CO DR0065923) |
| 207X00000X Orthopaedic Surgery (Licence: GA 93247) | |
| Enumeration Date | 2016-04-02 |
| Last Update Date | 2022-10-17 |