| NPI | 1699893529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME174981) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA OS012625) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2025-09-03 |