| NPI | 1689070906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: FL ME147366) |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2014-11-13 |
| Last Update Date | 2021-06-25 |