| NPI | 1710972633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ME MD15369) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: ME 015369) |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2018-10-10 |