| NPI | 1134649775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ME MD27281) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301502440) |
| 207X00000X Orthopaedic Surgery (Licence: MA 291003) | |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: ME MD27281) | |
| Enumeration Date | 2017-06-25 |
| Last Update Date | 2023-09-08 |