| NPI | 1871550780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NM MD2024-1070) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME112364) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2024-12-06 |