| NPI | 1962403261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME0067527) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME67527) |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2025-01-10 |