| NPI | 1508019779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME135286) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35098080) |
| 207X00000X Orthopaedic Surgery (Licence: ME MD22477) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: OH 35098080) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: FL ME135286) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: ME md22477) | |
| Enumeration Date | 2008-10-31 |
| Last Update Date | 2022-12-19 |