| NPI | 1619954336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME0074812) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NH 8048) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2020-11-18 |