| NPI | 1407472418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME173689) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT220014) |
| Enumeration Date | 2020-06-25 |
| Last Update Date | 2026-07-23 |