| NPI | 1033319892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME101808) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: FL ME101808) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: MD D66167) | |
| 207X00000X Orthopaedic Surgery (Licence: NY 232035) | |
| 207X00000X Orthopaedic Surgery (Licence: MD D66167) | |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: FL ME101808) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NY 232035) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: FL ME101808) | |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2026-06-18 |