| NPI | 1811494446 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME169061) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2023-00630) |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2024-07-19 |