| NPI | 1285676700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NH 17267) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: ME 012947) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: ME 012947) | |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2017-03-07 |