| NPI | 1518947290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2017-01276) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME118045) |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2024-01-24 |