| NPI | 1447614227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME155729) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD D91304) |
| Enumeration Date | 2016-04-07 |
| Last Update Date | 2025-05-27 |