| NPI | 1649560814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: FL ME147317) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD460563) |
| 207X00000X Orthopaedic Surgery (Licence: FL ME147317) | |
| Enumeration Date | 2011-04-08 |
| Last Update Date | 2020-12-30 |