| NPI | 1790883601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME30380) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME0030380) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2022-01-27 |