| NPI | 1740660430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME150934) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL TRN21698) |
| 207X00000X Orthopaedic Surgery (Licence: NC 2020-00293) | |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2021-08-30 |