| NPI | 1770087710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME168223) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 321520) |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2024-08-09 |