| NPI | 1386803674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME124715) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 253249) |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2022-07-21 |