| NPI | 1285015776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME164805) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD479329) |
| Enumeration Date | 2015-06-10 |
| Last Update Date | 2023-09-13 |