| NPI | 1265813737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME150089) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL 150089) |
| Enumeration Date | 2015-06-10 |
| Last Update Date | 2021-07-26 |