| NPI | 1982604088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME49803) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CO DR.0036832) |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2026-04-20 |