| NPI | 1851391577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 35076815) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: ME 216486) |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2023-11-03 |