| NPI | 1902861560 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VT 0420009792) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: ME MD27299) |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2024-06-10 |