| NPI | 1316047525 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME0068406)  | 
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: FL ME68406)  | 
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: FL ME0068406)  | |
| Enumeration Date | 2006-09-25 | 
| Last Update Date | 2022-04-05 |