| NPI | 1528030616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN 26514) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME148489) |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2025-06-26 |