| NPI | 1437316833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: FL ME106837) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME106837) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: FL ME106837) | |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2023-06-05 |