| NPI | 1528405131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME136636) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL TRN18660) |
| Enumeration Date | 2013-05-23 |
| Last Update Date | 2022-10-04 |