| NPI | 1295149821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME149600) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MS 27369) |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2021-07-15 |