| NPI | 1992813877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME106782) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC 27142) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2025-11-03 |