| NPI | 1750390936 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 90335) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME104686) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2023-08-18 |