| NPI | 1356501332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME112423) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: FL ME112423) |
| 207X00000X Orthopaedic Surgery (Licence: PA mt190458) | |
| Enumeration Date | 2008-06-12 |
| Last Update Date | 2023-05-05 |