| NPI | 1194974824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME114829) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH App submitted 7/08) |
| Enumeration Date | 2008-09-18 |
| Last Update Date | 2022-04-20 |