| NPI | 1013283019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME134831) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2017-00012) |
| Enumeration Date | 2012-03-24 |
| Last Update Date | 2022-06-10 |