| NPI | 1790745164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME109839) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD070425L) |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2024-07-25 |