| NPI | 1396882304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME100957) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: FL ME100957) |
| 207X00000X Orthopaedic Surgery (Licence: MD P18112) | |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2011-11-23 |