| NPI | 1376595561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME0049140) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 30090) |
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: FL ME49140) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2019-09-24 |