| NPI | 1326081019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME65326) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2003-00264) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2025-06-11 |