| NPI | 1841454790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 90457) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME116710) |
| 207X00000X Orthopaedic Surgery (Licence: CO DR.0059034) | |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2022-08-11 |