| NPI | 1881896108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME104554) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: FL ME104554) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NE 24204) | |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2026-01-12 |