| NPI | 1770825846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME149789) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35.125456) |
| Enumeration Date | 2013-03-26 |
| Last Update Date | 2024-01-02 |