| NPI | 1821066390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME143720) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AL 9280) |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2020-03-24 |