| NPI | 1811155450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: FL ME127463) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME127463) |
| 208D00000X General Practice (Licence: KY 47294) | |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2026-04-06 |