| NPI | 1720341878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME136271) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301100790) |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2026-01-12 |