| NPI | 1124331137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME164799) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 279136) |
| Enumeration Date | 2010-07-19 |
| Last Update Date | 2023-09-22 |