| NPI | 1689864233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NH 16000) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: ME MD20727) |
| 208600000X Surgery (Licence: WA ML20008868) | |
| 207X00000X Orthopaedic Surgery (Licence: FL ME112516) | |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2015-10-12 |