| NPI | 1023421971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: FL ME145107) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA L-259469) |
| 207X00000X Orthopaedic Surgery (Licence: FL ME145107) | |
| Enumeration Date | 2014-06-09 |
| Last Update Date | 2021-08-08 |