| NPI | 1144423351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME114795) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2009-00137) |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2026-03-09 |