| NPI | 1609845312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME159582) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD054285L) |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2023-02-02 |