| NPI | 1699750489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME134081) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 9701725) |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2019-08-07 |