| NPI | 1669828794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME158033) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OK 32409) |
| Enumeration Date | 2016-05-07 |
| Last Update Date | 2022-09-07 |