| NPI | 1184787228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: FL ME118027) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH9310) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2022-07-28 |