| NPI | 1902197973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MD D83420) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME150173) |
| Enumeration Date | 2011-04-26 |
| Last Update Date | 2022-04-15 |