| NPI | 1346270881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME104621) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC 24060) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: FL ME104621) | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2026-08-03 |