| NPI | 1750336046 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 078584) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME 0098607) |
| 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: FL ME98607) | |
| 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: FL ME98607) | |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2022-07-21 |