| NPI | 1629697727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2026-03092) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME174148) |
| Enumeration Date | 2020-04-09 |
| Last Update Date | 2026-07-14 |