| NPI | 1043278948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME 24909) |
| Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: FL ME 24909) |
| 207Q00000X Family Medicine (Licence: FL ME 24909) | |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2015-03-18 |