| NPI | 1063893220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2022034935) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME148643) |
| Enumeration Date | 2015-06-13 |
| Last Update Date | 2022-10-25 |