| NPI | 1386272854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME180914) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN 73192) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: FL ME180914) | |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2026-08-31 |