| NPI | 1063472108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: FL ME0066584) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME0066584) |
| 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: FL ME0066584) | |
| 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: FL ME0066584) | |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2019-05-27 |