| NPI | 1023281466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME 13065) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME 13065) |
| Enumeration Date | 2008-04-07 |
| Last Update Date | 2016-02-16 |