| NPI | 1174985048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: FL ME156698) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME156698) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL K550017894570) | |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2025-11-10 |