| NPI | 1659533545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 075264) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME100970) |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2025-04-30 |