| NPI | 1558547620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME147919) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD435726) |
| Enumeration Date | 2008-01-18 |
| Last Update Date | 2023-06-05 |