| NPI | 1437612074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME167747) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2025029353) |
| 207X00000X Orthopaedic Surgery (Licence: OK 34842) | |
| Enumeration Date | 2019-04-10 |
| Last Update Date | 2025-09-10 |