| NPI | 1801869052 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME90687) | 
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME90687) | 
| Enumeration Date | 2006-02-08 | 
| Last Update Date | 2021-01-27 |