| NPI | 1346668894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NE 32414) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME138693) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2020-06-05 |