| NPI | 1306238936 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME162729) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301114909) |
| Enumeration Date | 2015-02-18 |
| Last Update Date | 2024-04-29 |