| NPI | 1518020429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 52604-020) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME100953) |
| 207X00000X Orthopaedic Surgery (Licence: OH 35.085490) | |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2026-04-21 |