| NPI | 1407344526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME175265) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 1013027) |
| Enumeration Date | 2018-04-24 |
| Last Update Date | 2025-09-17 |