| NPI | 1386639508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: FL ME0064304) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME64304) |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2025-10-07 |