| NPI | 1417920364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME155637) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 219326) |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2025-03-20 |