| NPI | 1164869699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: FL ME135652) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME135652) |
| Enumeration Date | 2013-05-23 |
| Last Update Date | 2021-08-08 |