| NPI | 1639381759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A97202) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME106838) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2022-02-03 |