| NPI | 1669470795 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: FL ME0054695) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME0054695) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: FL ME0054695) | |
| 207X00000X Orthopaedic Surgery (Licence: FL ME0054695) | |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2015-01-08 |