| NPI | 1942274485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME0082101) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: FL ME0082101) |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2020-04-16 |