| NPI | 1568847523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME125344) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 311508) |
| Enumeration Date | 2015-07-20 |
| Last Update Date | 2021-07-20 |