| NPI | 1861804304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME141855) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101259266) |
| 207X00000X Orthopaedic Surgery (Licence: IL 036168190) | |
| 207X00000X Orthopaedic Surgery (Licence: MO 2024009620) | |
| Enumeration Date | 2014-06-02 |
| Last Update Date | 2024-04-17 |