| NPI | 1326046384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME137975) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: DC 4782) |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2021-10-09 |