| NPI | 1093125676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: FL ME145626) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2019-01449) |
| Enumeration Date | 2014-05-05 |
| Last Update Date | 2020-09-14 |