| NPI | 1811158249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME174513) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 071070) |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2026-01-30 |